Aerobic Exercise Increases Hippocampal Volume and Improves Memory in Persons with Multiple Sclerosis: Pilot Findings from a Randomized Controlled Trial
Victoria Leavitt, West Orange, NJ, Amanda Cohen, West Orange, Amanda Farag, West Orange, Christopher Cirnigliaro, West Orange, NJ, Nancy Chiaravalloti, West Orange, NJ, James F. Sumowski, West Orange, John DeLuca, West Orange
OBJECTIVE: Aerobic exercise improves memory and promotes hippocampal neurogenesis in non-human animals. Its efficacy has not been verified in a memory-impaired neurologic sample. Here, a randomized controlled trial of aerobic versus non-aerobic exercise was piloted in multiple sclerosis (MS) patients with memory impairment.
BACKGROUND: MS leads to prominent hippocampal atrophy: as much as 10% reduction of hippocampal volume is seen in persons with relapsing-remitting MS (RRMS), even after only five years. Hippocampal atrophy is linked to memory deficits; indeed, more than 50% of MS patients suffer memory impairment, with negative consequences for quality of life. There are currently no effective memory treatments for MS, either pharmacological or behavioral.
DESIGN/METHODS: Pilot data were collected from two ambulatory, memory-impaired MS participants randomized to non-aerobic (stretching) and aerobic (stationery cycling) conditions. Baseline and follow-up measurements: high-resolution MRI (neuroanatomical volumes), fMRI (functional connectivity), and memory assessment. Intervention was 30 minute sessions 3 times per week for 3 months. R
RESULTS: Aerobic exercise resulted in a 16.5% increase in hippocampal volume and a 53.7% increase in memory, as well as a large increase in hippocampal resting-state functional connectivity. In contrast, non-aerobic exercise resulted in relatively no change in hippocampal volume (2.8%) or memory (0.0%), and no changes in hippocampal resting-state functional connectivity. Effects of aerobic exercise were specific to the hippocampus and memory, as there were no comparable changes in overall cerebral gray matter (2.4%) or in non-hippocampal deep gray matter structures (thalamus, caudate: -4.0%), nor were there any changes in non-memory cognitive functioning (mean change: 0.0%).
CONCLUSIONS: This is the first evidence for aerobic exercise to increase hippocampal volume, hippocampal connectivity, and improve memory in MS. Aerobic exercise represents a cost-effective, widely available, natural, and self-administered treatment with no adverse side effects that may be the first effective memory treatment for MS patients.
Victoria Leavitt, West Orange, NJ, Amanda Cohen, West Orange, Amanda Farag, West Orange, Christopher Cirnigliaro, West Orange, NJ, Nancy Chiaravalloti, West Orange, NJ, James F. Sumowski, West Orange, John DeLuca, West Orange
OBJECTIVE: Aerobic exercise improves memory and promotes hippocampal neurogenesis in non-human animals. Its efficacy has not been verified in a memory-impaired neurologic sample. Here, a randomized controlled trial of aerobic versus non-aerobic exercise was piloted in multiple sclerosis (MS) patients with memory impairment.
BACKGROUND: MS leads to prominent hippocampal atrophy: as much as 10% reduction of hippocampal volume is seen in persons with relapsing-remitting MS (RRMS), even after only five years. Hippocampal atrophy is linked to memory deficits; indeed, more than 50% of MS patients suffer memory impairment, with negative consequences for quality of life. There are currently no effective memory treatments for MS, either pharmacological or behavioral.
DESIGN/METHODS: Pilot data were collected from two ambulatory, memory-impaired MS participants randomized to non-aerobic (stretching) and aerobic (stationery cycling) conditions. Baseline and follow-up measurements: high-resolution MRI (neuroanatomical volumes), fMRI (functional connectivity), and memory assessment. Intervention was 30 minute sessions 3 times per week for 3 months. R
RESULTS: Aerobic exercise resulted in a 16.5% increase in hippocampal volume and a 53.7% increase in memory, as well as a large increase in hippocampal resting-state functional connectivity. In contrast, non-aerobic exercise resulted in relatively no change in hippocampal volume (2.8%) or memory (0.0%), and no changes in hippocampal resting-state functional connectivity. Effects of aerobic exercise were specific to the hippocampus and memory, as there were no comparable changes in overall cerebral gray matter (2.4%) or in non-hippocampal deep gray matter structures (thalamus, caudate: -4.0%), nor were there any changes in non-memory cognitive functioning (mean change: 0.0%).
CONCLUSIONS: This is the first evidence for aerobic exercise to increase hippocampal volume, hippocampal connectivity, and improve memory in MS. Aerobic exercise represents a cost-effective, widely available, natural, and self-administered treatment with no adverse side effects that may be the first effective memory treatment for MS patients.
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